Passionate Rivals Page 6

  Emmett felt the loneliness now. Maybe Syd, less than an arm’s length away, did too. She’d spent the last four years ignoring her needs and blocking out her pain and disappointment to earn this final mark of success. Now what? Her heart beat faster in her chest, but she kept her breathing as even and quiet as Syd’s. Never show fear.

  “We need to integrate our residents at every level, and it’s the chief resident’s responsibility to see that that happens.” Maguire took them both in with her direct, unwavering gaze.

  The sword was about to fall, and Emmett steeled herself for the blade.

  “You both know the case requirements for you to sit for your boards—due to the unusual circumstances, we’ve received special dispensation for the fifth years who will have only been here for one full year. However, the two-hundred-minimum case requirement as operating surgeon for chief residents as well as twenty-five major cases as teaching assistant still stands.”

  Emmett mentally checked her surgical log. She was okay as long as she had her pick of cases the last year—at least she had been.

  “I sat down with the other members of the training committee last night,” Maguire said, “and we went through everyone’s case logs, board scores, and evaluations in order to assign residents where they needed experience.” Her gaze shifted to Emmett. “McCabe, you’re a little heavy on trauma cases and light in peds surgery and transplant. You’re also light on teaching cases.”

  “Uh…I figured I could count peds trauma as peds cases,” Emmett said.

  Maguire smiled. “Trauma trumps peds at this point, especially”—she looked at Syd—“since Stevens—all the former Franklin residents—are light on trauma.”

  Syd leaned forward, the first move she’d made since shaking hands with Emmett. “Franklin is a level two center, Chief. We all have experience with routine traumas, and all the seniors are ACLS and ATLS certified.”

  “I am aware, Dr. Stevens,” Maguire said mildly.

  “Yes, Chief.” Syd sat back.

  Emmett admired the move. Points to Stevens for standing up for her people.

  “But,” Maguire said, “I want every resident to have experience with major traumas. So here’s the plan.”

  Chapter Six

  Syd was still processing when she walked out of Chief Maguire’s office. The administrative wing was clear and quiet at the beginning of the day. No patients came down this hallway, and considering they were in the surgical wing, all the offices were empty. Everyone was in the OR. That was the only place a surgeon ever wanted to be. The printout of the new surgical service assignments dangled from her right hand. She didn’t even want to think about what Jerry and Dani would say when she told them, let alone the junior residents. She stopped a few feet down the hall and looked at Emmett. “Does anyone really think this will work?”

  “Someone must,” Emmett muttered.

  Syd couldn’t imagine what Emmett was feeling right now. Short of being royally ticked off, that was. And really, she couldn’t blame her. She would absolutely feel the same way in Emmett’s place. Surviving a surgical residency was pretty much a tightrope act without a net, where the slightest disruption in balance could drop you into free fall. This was a damn big shift in everyone’s equilibrium. But she couldn’t worry about Emmett right now, could she? Emmett wasn’t her problem, and none of this was her doing. She hadn’t been responsible for the government deciding to cut funding for medical training programs by 60 percent, and she certainly wasn’t responsible for PMC deciding to expand its program and take in the Franklin residents.

  PMC had made a smart move. After all, everyone knew residents were inexpensive labor, and hospitals benefited from their presence. Residents got paid, sure, but not as much as salaried attending physicians, and hospitals always needed willing bodies to staff the shifts no one else wanted. Residents worked around the clock, and even though they weren’t supposed to work more than twenty-four hours in a row without time off, they frequently did. If they didn’t tell, who would know, and every resident was in a race to beat out all the others for the best cases and the most OR time. No one would report working over the mandated hours, especially not now when every resident would be scrambling to rack up the right cases. The cases that counted for the boards.

  “What now?” Syd said finally.

  Emmett leaned back against the wall and regarded her with hot, dark eyes. Eyes so dark the blue looked purple. Yep, she was pissed, all right.

  “I guess the first thing we should do is round up our people and break the news.”

  “I don’t know why Maguire didn’t do that this morning,” Syd said.

  “I do.” Emmett’s face was a study in stony anger. “There would’ve been a riot.”

  “This isn’t great for any of us, you know,” Syd said, tired of bearing the brunt of everyone’s frustration. She was just as frustrated and worried and angry too.

  “Yeah, I get that. But you know, we weren’t the ones getting screwed until an hour ago.” Emmett blew out a breath. She hadn’t asked for this, and no one had asked her how she felt about having her entire future potentially derailed. None of the PMC residents had a choice.

  “Well, that certainly gives me and the rest of the Franklins an advantage.” Syd snorted. “We had almost twenty-four hours to get over being screwed. But cheer up. You ought to start feeling better before long.”

  “Great.” Emmett pressed her lips together. She knew somewhere in the back of her mind that this was no one’s fault, but right now, her rational mind was not in control. All she knew was everything she’d planned and worked for had just gone up in smoke. Not only that, she was somehow going to have to learn to work with Syd, which not only felt weird, it felt dangerous. “Why are you even here?”

  “What?” Syd narrowed her eyes. “I thought your chief made it clear—”

  “No,” Emmett growled. “Not about why the Franklins are here, why are you here? You were an intern five years ago. You weren’t even at Franklin. You should be finishing up at University—”

  Syd’s chin came up and her eyes grew glacial. “I’m a fourth year Franklin surgical resident. Where I did my internship is ancient history, and not relevant.”

  And nobody’s business.

  Emmett blinked. She got the unspoken message loud and clear. The frost in the air made her skin itch. Any other day, with anyone else, she wouldn’t have pushed, but maybe the past wasn’t as over and gone as she’d thought. Syd had disappeared without a single word—she hadn’t answered her phone or texts or returned messages. The hospital operators wouldn’t page her. And Emmett had had no idea how else to reach her. Now here she was, acting as if they’d never even met.

  “Look, it isn’t as if I don’t know—”

  “You don’t. You don’t know anything about me. What happened years ago doesn’t matter now. The only thing that matters is figuring out how to get through the next year.”

  Emmett stiffened. “Understood. You heard the chief—the residents need to get the new rotation schedules stat.”

  “Okay then. I’ll page the Franklin…” Syd’s lips tightened. “I’ll page the new PMC residents, and you’ll handle the others?”

  Scorn laced her voice.

  “Fine.” Emmett looked at the time on her phone. “Frickin’ hell. I’m going to miss my eight o’clock case. This is going to screw up the OR coverage all morning. I have to go.”

  “Do you think you could show me where the locker room is first?” Syd gestured to her T-shirt with the Charlie Brown image and frayed blue jeans sheepishly. “This is all I had in my locker at Franklin. I need scrubs.”

  “Yeah, sure.” Emmett got it. Scrubs were armor. As good as a Superman cape. “Come with me.”

  As Emmett led her through a warren of hallways, Syd tried to imprint the route on her mind. She needed to learn the shortcuts as quickly as she could. She was suddenly responsible for half of all the residents in the training program, and the last thing she wanted to do was
stumble around like a first year resident. She at least needed to look like she belonged.

  “The locker room is across the hall from the surgical lounge,” Emmett said, taking her up two flights of stairs to the third floor. “The TICU and the SICU—”

  “Yes,” Syd pointed to signs on the wall with arrows indicating the trauma and surgical intensive care units. “I got that. Who’s in charge once the patients get there? Us or the intensive care people?”

  “Good question.”

  Syd took hope when Emmett gave her a look that came close to suggesting they were on the same side.

  Emmett went on, “We handle the wound care and immediate post-op fluids. The ICU docs will order meds and monitor general status. Don’t let them touch any dressings, tubes, drains, sutures—”

  “Are you kidding?” Syd laughed. “No chance.”

  “Exactly.”

  Emmett grinned, and Syd flushed as if she’d just been handed the game ball. Really. As if it mattered what Emmett McCabe thought of her.

  “Okay, so…” Emmett slowed as they started down the hall. “Fifteen OR rooms, five dedicated to OB / GYN and labor and delivery. We keep one room empty on a rotating basis, so it will be open if a trauma comes in. If that one is in use, trauma bumps any case, any time.”

  “What happens if we get multiple traumas and need more than a couple of rooms?”

  “If we don’t have a room up here open, we can do anything except bypass downstairs in trauma admitting.” Emmett shrugged. “I think if we had to, we could do that too.”

  “Okay.” Syd’s pulse quickened as she mentally reshuffled her picture of what she’d be facing. She’d seen trauma cases at Franklin, but usually isolated injuries in stable patients. Gunshots, fractures, blunt force trauma. This was going to be a whole new game. “What about attending coverage for trauma alerts?”

  “There are two trauma fellows, and three rotating trauma attendings. You already know Maguire—she’s the chief. Surgical residents and fellows do the initial assessment and resuscitation. If you get there fast, you can get the case.”

  “Sounds like a free-for-all.”

  Emmett grinned, and this time, the grin looked genuine. A happy, sharky grin. “Oh, it is.”

  The grin fooled Syd into forgetting she and Emmett still had major hurdles ahead and she let down her guard. “Look, Emmett, about all of this, I—”

  Emmett’s expression shuttered. “Let’s get our people organized before we lose any more time. You can talk to your people in the locker room if you want to. I’ll take my team to the cafeteria.”

  “Fine.” Syd pushed open the door to the surgical locker room as Emmett strode away.

  Your people. My team.

  So much for no more them and us. Did Maguire really think it was going to be that simple?

  * * *

  Honor stopped at the end of the bed where her second year resident was closing the laceration on the young man hit by a car. She automatically checked the monitors at the head of the table. All good. Time to clear the trauma bay before another emergency came rolling in. “You just about done here?”

  Armand clipped the last suture in the row of 5-0 nylons he’d placed in the bicyclist’s forehead. “Just waiting on the CT results, but his neuro check is fine. Ortho has him scheduled for an ORIF of the tibia fracture this afternoon.”

  “Good. Are you sending him to the floor pre-op?”

  “As soon as I see the CT.”

  Honor nodded. “Good work.” Spinning around, she nearly bumped into her wife. The first jolt of pleasure was familiar and never diminished by how many times she’d experienced it. “Hey. I didn’t expect to see you down here this morning.”

  “Everything quiet?” Quinn asked.

  “So far. Why? Something happening?”

  “I’m about to head to the OR for a couple of hours. Just wanted to make sure everything was under control before then.”

  Honor frowned. Quinn wasn’t one to worry about situations that hadn’t happened yet. She dealt with realities, not possibilities. She slid her arm through Quinn’s and tugged her away from the patient’s bedside. “What’s going on?”

  Quinn blew out a breath. “This residency situation is going to destabilize things for a while. It’s like dumping an entire bunch of interns into the mix, except they’re not interns. All the same, the new residents don’t know the facility, our routines, or each other. There’s no cohesion.”

  “And I suppose the PMC veterans aren’t exactly stepping up to lend a helping hand.”

  “Blame them?” Quinn grimaced.

  “Of course not. You knew this would happen.”

  “I did, and we’ll weather it. But it’s going to be rocky going for a while.”

  “What’s really bugging you?”

  Quinn sighed. “It’s not fair to any of them, and I know it, but I can’t say it. They don’t need sympathy—they need to dig their way back onto solid ground. And the only ones who can do that are them.”

  “You think any of them will jump ship?”

  “There’s a possibility some of the junior residents, especially the shaky ones, will go under with more competition…” She glanced around the trauma bay. “And some of them will have to be cut. We have enough room for everyone, but only if they manage to make it above the high-water line. We can’t keep anyone who falls behind.”

  “Including the ones who have been here the whole time?”

  “Including them.”

  “All of these things have already occurred to you. So what else is going on?”

  Quinn’s gaze deepened. “You always know, don’t you.”

  Honor smiled. “You mean when something is bugging you? Lots of practice.”

  Quinn laughed. “Oh, come on. I’m not the moody type.”

  “That’s true, you’re not. Broody sometimes. Dark and twisty sometimes.”

  Quinn threaded her arm around Honor’s waist and pulled her into an empty trauma bay, yanking the curtain halfway closed behind her. She kissed her swiftly. “I thought you liked me broody and twisty.”

  Honor caught her breath. They were married with two kids, but Quinn’s touch streaked through her with as much heat as the first time. Every time. All the same, they hadn’t had an encounter in the hospital for a long while. “I’ve missed this.”

  “At your service,” Quinn murmured.

  Honor kissed Quinn back, then pressed a palm firmly against her chest and pointed to herself with the other hand. “ER chief here. I have a reputation to maintain.”

  “Mm-hmm.” Quinn pulled her closer, kissed her again. “You think I’m going to sully it?”

  Honor laughed and stepped back. “You can sully it all you want at home. Tonight.”

  “Black belt test.”

  Honor caught her breath. “And how could I have forgotten that. God. I love my children. You think we could send them to camp?”

  Quinn chuckled. “You’d be miserable within three days.”

  “Probably two. After the test?”

  “It’s a date.”

  Honor poked Quinn’s chest. “And you’re still broody. Why?”

  “McCabe. She’s…”

  “Your favorite?”

  “I don’t have favorites.”

  Honor lifted a brow. Waited.

  “Okay, I’m not supposed to have favorites. But she’s my first pick for a trauma fellowship when she finishes, if she wants it. And I hope to hell she does.”

  “But?”

  “I can’t play favorites, no matter what I think. And she’s going to have tough competition this year.”

  “From one of the Franklins?”

  Quinn nodded. “Sydney Stevens. She’s exceptional. Her board scores are higher than McCabe’s, but not by much. They’re both top tier there. McCabe has more trauma experience, but Stevens has more overall OR experience.” She shook her head. “They’ll be competing for choice of chiefs’ rotations next year. I had to spell it out for them, a
nd they’re not happy. They’re going to be bumping heads all year long.”

  “Competition is good for them. It will lift both their games. You’ve been there—you know.”

  “I know. And ordinarily I wouldn’t mind some healthy competition, but the circumstances are unusual, and they’re going to have to adjust pretty quickly.”

  “And you are going to have to let them figure it out on their own.”

  “I know you’re right,” Quinn said. “You’ll probably see a lot of them down here. If they get too territorial—”

  “I’ll keep the bloodshed to a minimum,” Honor said. “Go to the OR. We’ve got this covered.”

  “Thanks.” Quinn grinned. “See you tonight.”

  “Oh yes, you will.”

  * * *

  Emmett paged Zoey, Sadie, and Hank stat to the cafeteria. They arrived out of breath a minute after she sat down with her third cup of coffee. Zoey dropped into a chair on her right, Sadie sat across from her, and Hank squeezed in on her left.

  “So?” Zoey said. “What the frick is going on? What did the chief want with you?”

  “All the services are being reorganized,” Emmett said flatly. She spread out the sheet in front of her.

  “What does that mean?” Sadie demanded. A strand of her flame-colored hair had come loose from her ponytail, and she pushed it impatiently behind her ear. That was Sadie, fiery and hot tempered. She’d been that way in bed too, which was probably why Emmett had broken her rule about repeats. More times than she’d meant to. She hoped she’d be able to smooth things over with a little more time, but today was not going to be that day.